Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort
Authors: Marc D. Ryser, Ruth B. Etzioni
Journal: Annals of Internal Medicine (2022)

LettersOctober 2022Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening CohortMarc D. Ryser, PhD and Ruth B. Etzioni, PhDMarc D. Ryser, PhDDepartment of Population Health Sciences, Duke University Medical Center, and Department of Mathematics, Duke University, Durham, North CarolinaSearch for more papers by this author and Ruth B. Etzioni, PhDProgram in Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WashingtonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0277 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We thank the correspondents for their comments and appreciate the opportunity to clarify certain aspects.Dr. Migowski is correct to note that the rate of overdiagnosis depends on the frequency of screening. However, our overdiagnosis estimate is not specific to the screening pattern of our study cohort. Rather, the cohort data were used only to learn about the natural history of breast cancer. Given the learned natural history, we then predicted schedule-specific overdiagnosis rates (that is, the frequency of overdiagnosis among screen-detected cases of cancer under biennial mammography between the ages of 50 and 74 years). The ability ...References1. Gulati R, Feuer EJ, Etzioni R. Conditions for valid empirical estimates of cancer overdiagnosis in randomized trials and population studies. Am J Epidemiol. 2016;184:140-7. [PMID: 27358266] doi:10.1093/aje/kwv342 CrossrefMedlineGoogle Scholar2. Heidinger O, Heidrich J, Batzler WU, et al. Digital mammography screening in Germany: impact of age and histological subtype on program sensitivity. Breast. 2015;24:191-6. [PMID: 25687106] doi:10.1016/j.breast.2014.12.009 CrossrefMedlineGoogle Scholar3. Ernster VL, Ballard-Barbash R, Barlow WE, et al. Detection of ductal carcinoma in situ in women undergoing screening mammography. J Natl Cancer Inst. 2002;94:1546-54. [PMID: 12381707] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Marc D. Ryser, PhD; Ruth B. Etzioni, PhDAffiliations: Department of Population Health Sciences, Duke University Medical Center, and Department of Mathematics, Duke University, Durham, North CarolinaProgram in Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-3577. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEstimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Marc D. Ryser , Jane Lange , Lurdes Y.T. Inoue , Ellen S. O’Meara , Charlotte Gard , Diana L. Miglioretti , Jean-Luc Bulliard , Andrew F. Brouwer , E. Shelley Hwang , and Ruth B. Etzioni Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Arn Migowski Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Charles Harding , Dmitriy Burmistrov , Marybeth Pompei , Francesco Pompei Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Per-Henrik Zahl and Karsten Juhl Jørgensen Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Sherwin Chiu , Benjamin Williams , Kevin Shahbazian , Michelle V. Lee Metrics October 2022Volume 175, Issue 10Page: W116-W117KeywordsBreast cancerBreast cancer screeningCancer epidemiologyCancer screeningMammographyNatural history of diseaseOverdiagnosisPrevention, policy, and public health ePublished: 18 October 2022 Issue Published: October 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...